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The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
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Proximal Hamstring Tears (High Hamstring Injury)
Proximal hamstring injuries involve tears or degeneration of the hamstring tendons where they attach to the sitting bone (ischial tuberosity) in the buttock, causing deep buttock pain, difficulty sitting, and weakness with running or bending - they occur from sudden sprinting in athletes or gradual overuse in runners, with treatment ranging from rest and physiotherapy for partial tears (70-80% successful) to surgical reattachment for complete tears or failed conservative treatment.
📖What is Proximal Hamstring Tears (High Hamstring Injury)?
Proximal hamstring injuries involve tears or degeneration of the hamstring tendons where they attach to the sitting bone (ischial tuberosity) in the buttock, causing deep buttock pain, difficulty sitting, and weakness with running or bending - they occur from sudden sprinting in athletes or gradual overuse in runners, with treatment ranging from rest and physiotherapy for partial tears (70-80% successful) to surgical reattachment for complete tears or failed conservative treatment.
🔬What Causes It?
- Sudden hamstring overload during sprinting (explosive acceleration causing tendon to tear from bone—common in sprinters, football, rugby)
- High kick or forced hip flexion with knee extended (stretches hamstring maximally—martial arts, hurdling, dance)
- Chronic overuse and degeneration (long-distance runners, triathletes—gradual tendon breakdown without acute event)
- Water skiing falls (forced hip flexion with knee straight—classic mechanism for complete avulsion)
⚠️Risk Factors
You may be at higher risk if:
- Sprinting and explosive sports (track and field, football, rugby—sudden acceleration increases tear risk)
- Long-distance running (repetitive loading causes chronic tendinopathy predisposing to tears)
- Previous hamstring strains (scar tissue weaker than normal tendon—re-injury risk 25-40%)
- Inadequate warm-up or flexibility (tight hamstrings more prone to injury during explosive movements)
- Age over 40 years (tendon degeneration increases with age—chronic tendinopathy more common)
🛡️Prevention
- ✓Adequate warm-up before sprinting and explosive activities (dynamic stretching, gradual acceleration—reduces acute tear risk)
- ✓Eccentric hamstring strengthening (Nordic hamstring curls proven to reduce hamstring injury risk 50-70%—perform 2-3 times weekly during training)
- ✓Gradual progression of running mileage and speed (avoid sudden spikes in training volume—increases overuse tendinopathy risk)
- ✓Address previous hamstring injuries fully before returning to sport (complete rehabilitation reduces re-injury risk from 40% to 15%)